HomeMy WebLinkAbout002-103-18-1600-LUP-2013-060 �.
Application for Land Use Permit(*Non-shoreland*) �
• County of Sawyer � � �`
10610 Main St.Suite 49 -Hayward WI 54843 � �,
� 715/6348288 � � `- �
`Property that is not located withfn 300'of a creek,rfver or stream or within 1000'of a flowage,lake or pond
or does not have any of the above waterbodies located wft6fn the property's boundaries. � _ �
CONSTRUCTION SHALL NOT BEGIN UNTIL ALL REQUIRED PERMITS HAVE BEEN ISSUED. �
SIGNATURE OF PROPERTY OWNER IS REQUIRED. USE BLACK INK OR PENCIL � r O
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Owner ' Builder UI
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Mailing Address � Mailing Address
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Gty State,Zip %a.o-�Q�-4334 City,SWte,Zip '
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Daytime Phone j ac.{�,�2yer�t,5 oa rp�ime Phone � r
Email: _�i; y — �
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Site address: %`'^i,1- � ,' r' •�C �� (Number and name of road) �,
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Proposed construdfon(check one): � -
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ONew or replacement dweiling/prfmary building.Number of bedrooms i° ?�
( )New or replacement accessory building �
(�ddition or aiteration to dweliing/primary buflding.Total number of bedrooms: : �' T
OAddition or alteration to accessory buildfng -
ONew business or use of existing buiidfng �'
OUse of land(such as mining,grading,fillfng) �
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Additional informatfon: �1
Construction Cost:Primary Structure$ �
Accessory Building:$ Addition:$ ' �
Describe what you are building.List each project separately. �
Project#1.Size of footprint: jl�ft.x % � ft= �3(o sq ft. m
Total sq ft: �Z�_ Hefght from grade to peak: �l✓ ` �
(T"his total includes additionai scories or lofrs.j y
Project#2.Sfze of footprint: ft.x ft= sq ft. ,g
Total sq ft: Height from grade to peak: i ,-.
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Project#3.Size of footprint: ft.x ft= sq ft. �
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Total sq ft: Height from grade to peak: -
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Show lot dimensions and indicate north. °'
(reaz lot line) '2
Draw the locatfon,size,and dimensions �
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of each structure on the property. � �
� ' ���R� '��� new structure.Show driveway access. � 3
�� Q ��.,1 �:�� Draw the location of the septic rystem �
Jdistance to structure. � o
Show location of an wetland. ~
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Show the dfstance from the structure to ` �
!U.( �'! �ir�yt- road centerline,lot lines,wetland,septic �
( rystem(drafnfleld and/or tank). D I
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Land Use Permib exoire one year from isaue date. � ' r.
I?f.[�f� �.� [��(� �. i "NO REFUNDS AFTER ISSUE OF PERMR. �
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� �pti� '"k LU / 'j I:' The undersigned ceAifies that lhe listed information and inten- (�
tions are tNe and correct,that atl work shall be performed in Z
�r I, , compliance with the requirements o(lhe Sawyer County o
Zoning Ordinance and thelaws and regulaUons ottha State of � _
Wisconsin.The undersigned person(s)hereby give pertnission
i- br access ro ihe property for onsite inspeciion.
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Original gnature of prope owner(or agent with Power of Attomey).
Fee$ ��% 4/1/11
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